II. Risk Factors: High Risk for Tuberculosis exposure and Infection (Tuberculosis Screening Indications)
- Recent Immigrants (within prior 5 years) from high risk countries (or extended travel to one of these regions)
- Africa (esp. Sub-saharan Africa)
- Asia (highest risk)
- Eastern Europe
- Central America
- South America
-
Immunocompromised conditions
- Human Immunodeficiency Virus (HIV)
- Immune modulators (e.g. Rheumatoid Arthritis)
- Diabetes Mellitus
- Close contacts of persons known or suspected to have TB
- Children exposed to adults in high-risk categories
-
Substance Abuse
- Tobacco Smokers
- Alcohol Abuse
- Intravenous Drug Abuse (or other Illicit Drug use)
- Residents and employees of high-risk congregate setting (e.g. homeless shelter, correctional facility)
- Medically underserved, low income populations (e.g. homeless)
- Health care workers
- Tb screening is recommended on newly hired staff
- Repeat testing after initial screening should be based on exposure risk
- Most U.S. healthcare workers are at low risk similar to general population and do not require routine interval testing
- Indications for repeat Tb Screening at intervals
- Known Tuberculosis exposure
- Healthcare workers serving high risk populations
- Healthcare workers where community TuberculosisPrevalence is higher
- Consider periodic screening questions for health care workers to risk stratify for testing
III. Resources
- Tuberculosis in Health Care Settings (CDC)